OBJECTIVE To discuss how to strengthen detail management to control hospital infection in operating room. METHODS The consciousness of controlling hospital infection,detail management as the key,integration of daily supervision examination with periodic inspection test and assessment,perfecting the detail management mechanism of hospital infection,and executing operation rules strictly were carried out. RESULTS The knowledge of hospital infection in staff members was improved,working efficiency raised,nursing level increased obviously,and the sterile operation infection rate dropped down. CONCLUSIONS Strengthening detail management is good for hospital infection control in operating room.

Aim To investigate the effects of stromal cell-derived factor-1α ( SDF-1α) on cell proliferation in primary cultured rat astrocytes and the possible mechanisms. Methods The primary cultured rat astr-cytes were treated with recombinant human SDF-1α at different concentrations, the cell proliferation was as-sessed by cell counting and 5-bromo-2’-deoxyuridine incorporation assay;intracellular calcium concentration was detected with calcium sensitive fluorescent probe;phorphorylation of extracellular regulated protein ki-nase1/2 ( ERK1/2 ) was determined by Western blot analysis;cell cycle transition was analyzed by flow cy-tometry analysis; mRNA expressions of cyclin A2 and cyclin B1 were determined by quantitative RT-PCR. Results Treatment of astrocytes with SDF-1α (5 -40 nmol·L-1 ) for 48 h induced significant cell prolifera-tion. SDF-1α at 20 nmol·L-1 increased the intracel-lular calcium concentration and the phosphorylation of ERK1/2. In addition, SDF-1α at 20 nmol·L-1 pro-moted the cell cycle transition from G0 to S and M pha-ses, and up-regulated the mRNA expressions of Cyclin A2 and Cyclin B1 . Conclusion SDF-1α significantly induces cell proliferation in primary cultured rat astro-cytes via enhancing calcium influx, ERK1/2 phospho-rylation, Cyclin expression and promoting cell cycle transition.

Objective To observe the changes of diameter of intrafusal fibers and capsule at equatorial region of rat soleus muscle spindle caused by hindlimb-unloading.Method Tail-suspended female rats were used as the model of hindlimb-unloading,all rats were randomly divided into 4 groups according to body weight.The four groups were exposed to tail-suspension for: 7 d,14 d,28 d and 0 d,respectively.The diameter of intrafusal fibers and capsule of single muscle spindle was measured and analyzed.Result The diameter of intrafual fibers,including nuclear-bag fibers and nuclear-chain fibers, were reduced slightly in both 7 d group and 28 d group and obviously reduced in 14 d group.The capsule diameter at equatorial region was obviously reduced in 7 d group.Conclusion Hindlimb-unloading can obviously reduce the diameters of intrafusal fibers and capsule at equatorial region of rat soleus muscle spindle.

Objective To investigate changes in cerebral white matter after transplantation of neural stem like cells (MS-NSCs) derived from the bone marrow mesenchymal stem cells, in rats with severe acute carbon monoxide poisoning. Method Forty Sprague-Dawley rats weighing 200 ～ 250 g were divided randomly into 4 groups: the normal control group, the poisoned control group, the BMSCs transplanted group and the MS-NSCs transplanted group (each group 6 rats). BMSCs were harvested from whole bone marrow in vitro, and then differentiated into MS-NSCs under the cock tail of certain growth factors, followed by BrdU labelling. The seed cells were infused into the brain via the left internal carotid artery 24 hours post poisoning. Remodelling of cerebral white matter was assessed using H & E staining, myelin staining and immunohistochemitry assay after 5 weeks later. Results Cellular transplantation improved the compactness and orderliness of cerebral white matter. BrdU-positive cells were found in the focal insulted areas of sparse white matter; and greater numbers of Brdu-Positive ceus were observed in the MS-NSCs group thar in the BMSCs group (P ＜0.05). Conclusions MS-NSCs participates in the remodeling of cerebral white matter in rats with severe acute carbon monoxide poisoning, and shows promising evidence as seed cells transplanted for brain tissue regeneration.

Objective To observe The clinical effect of Xingqihuoxue granule combined with low molecular weight heparin to prevent deep vein thrombosis after operation of lower limb fracture surgery.Methods60 patients from February 2014 to February 2015, were randomly divided into observation group 30 cases and the control group 30 cases.The control group received low molecular weight heparin, the observation group received Xingqihuoxue granule.Two groups of patients were followed up and recorded the changes related indicators.ResultsThe level of capillary plasma viscosity, hematocrit, red blood cell and aggregation index values of observation group patients after treatment were (1.52±0.11,41.78±2.30%, 2.19±0.16 points), than the control group (1.42±0.14,39.02±2.07%, 2.01±0.23 points), and the difference was significant (P<0.05).The level of platelets of observation group patients was (189.4±37.0)×10.9 / L, than the control group (259.3±40.1) × 10.9/L, and the difference was statistically significant (P<0.05).The level of PT and APTT of the observation group after treatment were (16.0±2.79,36.78±4.59) s, than the control group (13.96±2.94,33.14±4.47) s, and the difference was statistically significant (P<0.05).The adverse reaction ratio of observation group after treatment was 6.67%, lower than the control group 30.00%, and the difference was statistically significant (P<0.05).ConclusionsThe clinical treatment of Xingqihuoxue granule combined with low molecular weight heparin was better than low molecular weight heparin alone, and the side effects was lower.It is worthy of further research and application.

Objective:To compare the efficacy and safety between direct anterior approach (DAA) and posterior approach (PA) in total hip arthroplasty.Methods: This study evaluated postoperative results of 92 consecutive total hip arthroplasties performed by a single surgeon;44 from the DAA,and 48 from PA.The age,body mass index,operation time,blood loss,hospital stay,positioning of the artificial hip,postoperative Harris score and postoperative complications were recorded and analyzed.Results: Both the average age of the patients separately (58.0±11.9) years in DAA group and (61.0±10.4) years in PA group and the body mass index (25.1±3.7) in DAA group and (24.7±3.3) in PA group,showed no significant difference between the two groups.The DAA group had significantly reduced the hospital stay (3.8±1.7) days vs.(4.9±2.3) days for the PA group (P<0.05) and operation time was (76.0±17.4) min in DAA group,and (71.0±14.3) min in PA group (P>0.05).The amount of blood loss: in group DAA (238.0±55.3) mL,and in group PA (387.0±61.2) mL (P<0.05).There was no statistical difference in the positioning of the artificial hip: the cup anteversion in DAA group and PA group was 17.3°±5.3° vs.18.6°±5.1°,the cup inclination was 38.5°±5.7° vs.37.7°±5.2°.In DAA group,there was significantly less use of assistive devices [(24.6±7.8) d vs.(31.7±10.2) d,P<0.05],and the pain was significantly lower.Harris score at the end of 6 weeks of the follow-up: in DAA group 85.7±5.4,and in PA group 81.3±6.1 (P<0.05);at the end of the last follow-up: in DAA group 93.4±4.7,and in PA group 92.3±5.3 (P>0.05).Complications were encountered in the two groups.There were two intraoperative complications (4.4％),1 great trochanter fracture and 1 lateral cutaneous nerve injury in DAA group.No dislocation was observed in DAA group.One dislocations and 1 groin pain were recorded in PA group.No prosthesis loosening,deep vein thrombosis,sciatic nerve injury and other complications occurred in the two groups.Conclusion: Total hip arthroplasty using the anterior approach allows for superior recovery and better stability.

Objective To study the impact of Paeoniflorin (PF) on α-synuclein degradation pathway. Methods PC12 cells were treated with or without MPP+ (0.5mM) for 24 h, then treated with Paeoniflorin (50 uM) or Rapamycin (0.2 μg/ml) for 24 h. The proliferative activity of cells was detected with the MTT method , and then the protein expression levels of α-synuclein, microtubule-associated protein light chain 3 (LC3-II) and E1 were detected by Western Blot. The expressions of α-synuclein and LC3 were detected by confocal microscopy. Results (1) CAT and SOD activity were significantly decreased after PF and RAPA treatment compared with MPP+ (P < 0.001). (2)MPP+ activated both LC3-Ⅱand E1. MPP+ promoted the increase ofLC3-Ⅱ but inhibited E1. PF significantly upregulated both LC3-Ⅱ (autophagy) and E1 expression (ubiquitin-proteasome pathway) (P < 0.001), promoted degradation of α-synuclein, and reduced cell damage. (3) MPP+enhanced immunofluorescence signal of intracellular α-synuclein and LC3. Fluorescence intensity of α-synuclein decreasedafter PF treatment. Conclusion PF may significantly upregulate both autophagy and ubiquitin proteasome pathways, promote the degradation of α-synuclein and reduce cell damage. These findings suggest Paeoniflorin may be a potential therapy for neurodegenerative diseases.

Based on the Australian AR-DRGs, this research gathered the diagnosis related information on the first page of medical records and accomplished the computerization of data collection and analysis through the data-base of Shanghai Shenkang Hospital Development Center.According to the clinical practices, the DRGs model has been adjusted to complete the localization and a severity-based-DRGs model and grouping tool have been established for the municipal hospitals in Shanghai.

The severity of disease can be used to evaluate the current situation of patients as well as to predict the diseases outcome.In the meantime, the severity among different diseases has been more and more applied in the evaluation of the patients at hospital level.This study collected and summarized different types of international disea-ses grouping tools'characteristics and applications based on the severity of disease, and their suitability and practical values in hospital performance evaluation were compared and analyzed.

The performance evaluation is an effective method to guide the public hospitals behavior and pro-mote their sustainable development.The introduction of disease severity could make the performance evaluation sys-tem more scientific and reasonable, and encourage the hospitals to improve their technical skills and services ability. Based on the Shanghai diagnosis related groups system, a case-mix index ( CMI) was introduced and a severity score of disease was developed after the relative weight ( RW) adjustment to evaluate different types of disease severity in hospitals.The results have shown that CMI effectively reflects the patients'disease severity and the intensity of treat-ment in those hospitals taken into consideration.Therefore, the scientific indicators should be selected and the evalu-ation system should be improved thereby establishing an effective monitoring and dynamic adjustment mechanism and further developing the diagnosis related group application.